Nearly 90% of the 8 million individuals with Parkinson disease (PD) globally have disordered speech that diminishes their ability to communicate effectively. The inability of people to communicate severely impacts their quality of life affecting social, economic and psychological well-being. While these individuals could benefit from LSVT(R) LOUD, the only efficacious speech treatment for PD, their access is limited by physical immobility, remote location and reduced access to trained speech clinicians. Recent advances in telehealth offer potential solutions to this problem by affording "in-home" delivery of speech treatment protocols. LSVT LOUD is an ideal fit for such telehealth applications as it has a standardized treatment protocol with well- defined treatment outcome data, including sound pressure level (SPL), fundamental frequency (F0), and duration. Unfortunately, current efforts to deliver LSVT by telehealth delivery models have not established a procedure to insure the validity and reliability of these outcome data when they are obtained "on line". The goal of the present application is to integrate a newly developed software product with calibrated and validated outcome data (the LSVTC) into a telehealth delivery system. Our specific objectives are to: 1. Enhance the current LSVTC software to transmit calibrated treatment data for real time data exchange during telehealth sessions;2. Ensure that the LSVTC software is synchronized with the best freely available videoconferencing applications;3. Evaluate the reliability of LSVT LOUD treatment data (SPL, F0, duration) from clients with PD using the LSVTC with telehealth delivery as compared to using the LSVTC face-to-face;4.Evaluate the usability of the LSVTC telehealth delivery for an end-to-end treatment session with clients with PD. Our methods will include a partnership with Magpie Telecom Insiders for the technical development of software which will be combined with our research and clinical expertise for reliability and usability testing of this system. The feasibility data generated in this Phase l application will form a foundation for our Phase II research and development efforts that will establish the incorporation of our proprietary software system with a telehealth delivery product (LSVT(R) eLOUD), as a standard, data-driven universal delivery system for LSVT LOUD online. This integrated program will allow for greater access to LSVT LOUD treatment by individuals who live in remote areas or have physical immobility, while maintaining treatment fidelity via calibrated and reliable treatment data transmission. PUBLIC HEALTH RELEVANCE: Alternative modes of speech treatment delivery show great promise in overcoming many of the traditional barriers to access including geographical and mobility constraints. We are proposing the development of a telehealth system that will provide highly efficacious treatment for the speech and voice impairments associated with Parkinson disease. Such a system will provide greater access to LSVT LOUD treatment by individuals who live in remote areas or have physical immobility, while maintaining treatment fidelity via calibrated and reliable treatment data transmission.